This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Adenotonsillectomy is one of the most common surgical procedures performed on children . Adenotonsillectomy is performed with increasing frequency for obstructive sleep disorders in children . These obstructive sleep disorders have significant effects on quality of life in children , , . One of the key factors in sleep-related airway obstruction in otherwise healthy children is adenotonsillar hyperplasia. The standard treatment for Obstructive Sleep Apnea Syndrome (OSAS) in these children is adenotonsillectomy. Adenotonsillectomy has been performed using a variety of methods, most classically aimed at accomplishing complete removal of tonsils and adenoids. This surgery produces two postoperative morbidities: prolonged postoperative throat discomfort and the risk of immediate or delayed oropharyngeal hemorrhage. Techniques of subtotal tonsil removal (with adenoidectomy) to treat obstructive breathing disorders in children have been reintroduced over the past five years to try to reduce peri-operative morbidity. One such technique is powered intracapsular tonsillectomy and adenoidectomy (PITA) where a surgical microdebrider is used to completely remove the adenoids and to greatly debulk the tonsils. Surveys have shown improved recovery times, decreased postoperative pain, and improved patient satisfaction with this technique , . While it appears that sleep-disordered breathing is markedly improved with this technique, there is no study in the literature that objectively evaluates improvement of OSAS with this method. Our goal is to objectively measure the effect of PITA on sleep-related airway obstruction using pre- and post-operative polysomnographic data. We also plan to measure changes in quality of life (QOL) data as measured by changes in OSAS Quality of Life Survey (OSA-18), a validated sleep disorders questionnaire , . We hypothesize that patients who have PITA will have reduced airway obstruction during sleep after surgery, and most will have complete surgical cure.
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